Adaptive Reactions Hyperplasia, Hypertrophy, Metaplasia Obesity

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Adaptive reactions Hyperplasia, hypertrophy, metaplasia Obesity Dr. Attila Zalatnai Hyperplasia Increase of size of organs due to numerical excess of the cells Response to prolonged stimulus Organs /tissues that are capable of division Prerequisite: good blood supply Causative factors: - hormonal effects (adrenal cortex, prostate, male breast, acromegaly…) - prolonged antigenic stimulus (follicular hyperplasia) - drugs (cyclosporin A – gingival hyperplasia) - metabolic causes (obesity) - compensatory - unknown Benign prostatic hyperplasia Hormonal background Starts around 50 ys, peak incidence: 70-80 years Accumulation of the perirurethral glands and stroma Testosterone-production is imperative (not in eunuchs!) Accumulation of locally produced dihidrotestosterone (DHT) Major complication: urethral and bladder neck compression, the urine outflow is blocked) Beningn prostatic hyperplasia Hypertrophic urinary bladder Dilatation of the bladder Hydroureter Hydronephrosis Renal insufficiency Ascensing infections (pyelonephritis) Hypertrophy Increase in size of the organ, but the number of cells is unchanged Tissue that are non capable of division (muscle) Characteristically: against increased forces Increased diameter of te cells, increased DNA content Striated muscle (physical activity, sports) Heart muscle left chamber: hypertension, aortic stenosis right chamber: increased pulmonary resistance (cor pulmonale chr.) Congenital pylorus-stenosis Hypertrophy of the urinary bladder Hirschsprung-disease Metaplasia A mature tissue is replaced by an other mature tissue Indirect metaplasia (abnormal differentiation of reserve cells) Epithelial metaplasia: glandular epithelium squamous epithelium (squamous metaplasia) – bronchus, salivary glands /sialometaplasia/, cervix, pancreas glandular epithelium another type of glandular epithelium (intestinal metaplasia) (stomach; esophagus: Barrett-metaplasia; breast: apocrine metaplasia) Mesenchymal metaplasia: abnormal differentiation of pluripotent cells (cartilage, bone, etc.) Obesity Increased risk for Hyperlipidemia Atherosclerosis Diabetes mellitus Arthrosis Chronic cor pulmonale Cholelithiasis (6x) Varicosity Endometrial cancer, renal cancer .

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